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In a 187-person randomized trial, adults with obesity who combined an eight-hour eating window with supervised exercise lost more weight and body fat over 12 weeks than some comparison groups. The program did not produce a greater overall reduction in liver fat than standard care, and the measured weight and body-composition differences were no longer detectable one year later.
A 12-week randomized trial of 187 adults with obesity found that combining an eight-hour daily eating window with supervised exercise led to greater short-term weight and body-fat loss than standard care, while not reducing liver fat more than the comparison approaches overall. The TEMPUS study, led by researchers at the University of Granada and published in Nature Communications, also found that exercise improved cardiorespiratory fitness; the weight and body-composition differences were no longer detectable at a one-year follow-up.
Participants were randomly assigned to one of four groups: standard care, intermittent fasting, supervised exercise, or fasting combined with exercise. Across all groups, participants received education about the Mediterranean diet and physical activity. Those in the fasting groups ate within an eight-hour window each day, while exercise groups completed supervised strength training and high-intensity aerobic exercise.
The trial’s primary aim was to assess changes in liver fat measured by MRI and cardiovascular health. Liver fat decreased in all four groups, but researchers found no statistically significant differences between standard care and the interventions, or among the three intervention groups. Participants in either fasting group lost an average of about 2.2 kilograms more than the standard-care group. The combined program also produced greater body-fat loss than standard care and exercise alone.
Both groups assigned to exercise improved their cardiorespiratory fitness, a measure related to cardiovascular health. The study also reported that among participants with fatty liver at the start, about 30% in the combined fasting-and-exercise group no longer met the study’s diagnostic criteria after the program, compared with 6.5% in standard care. That subgroup result does not change the overall finding that the trial detected no significant between-group difference in liver-fat change.
Short-Term Weight and Fitness Gains
The findings suggest that time-restricted eating may add to short-term weight loss when used alongside exercise, while exercise itself was associated with better cardiorespiratory fitness. For adults with obesity, these outcomes matter because the study looked beyond weight alone, measuring body fat, liver fat and physical fitness as well.
However, the results do not establish that the combined approach produces lasting weight loss or a greater overall reduction in liver fat. At the one-year follow-up, the differences in weight and body composition were no longer detectable. The study therefore points to a potential short-term benefit, alongside the unresolved challenge of maintaining it after a structured program ends.
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How the TEMPUS Trial Was Designed
The research was part of the TEMPUS project, led by the PROFITH research group at the University of Granada’s Joint University Institute for Sport and Health (iMUDS), with collaborating biomedical and clinical research institutions in Granada. The trial included 187 adults with obesity, approximately half of them women, and compared fasting and exercise both separately and together against standard care.
In addition to the overall outcomes, researchers examined results by sex. Among men, combining fasting and exercise was associated with a greater reduction in liver fat than standard care; this difference was not observed among women. The researchers cautioned that these analyses do not establish that the intervention works differently by sex. The study was funded through Spain’s MICIU/AEI and the European Regional Development Fund.
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Durability and Liver-Fat Effects
The results do not show whether a longer or differently structured program could produce lasting weight loss or a sustained change in liver fat. One year after the program, group differences in weight and body composition were no longer detectable, and no between-group differences in liver-fat change were found at that follow-up.
The reported sex-specific result and the finding among participants who began with fatty liver require careful interpretation. The study authors said the sex analyses alone cannot establish different responses by sex. The supplied report also does not establish whether the subgroup change in diagnostic status would persist, or whether it translates into longer-term health benefits.
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Longer Trials and Maintenance Strategies
The researchers say further work should examine longer-term interventions, particularly for people with higher liver-fat levels, and test strategies that help participants maintain changes after a supervised program ends. The study report does not specify a date for a next TEMPUS trial or a planned follow-up publication.
For now, the findings are evidence from one 12-week randomized trial, not proof that the combined approach will have the same results for every person or remain effective after the program. Future studies will need to establish how durable the observed changes are and whether they can be maintained in routine settings.
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Key Questions
How many people took part in the trial?
187 adults with obesity participated, with approximately half women. They were randomly assigned to standard care, fasting, supervised exercise, or both fasting and exercise.
What did intermittent fasting involve in this study?
Participants assigned to fasting concentrated their meals within an eight-hour daily eating window. All groups also received education about the Mediterranean diet and physical activity.
Did the combined program reduce liver fat more than standard care?
Not in the overall trial comparison. Liver fat decreased in all groups, but the researchers found no statistically significant differences between the interventions and standard care. A separate finding among men does not establish that the intervention works differently by sex.
Did the benefits last after the program ended?
At the one-year follow-up, the trial found that weight and body-composition differences between groups were no longer detectable. The report says longer interventions and maintenance strategies should be studied.
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